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Diagnostic accuracy of MRI for identifying posterior element bone stress injury in athletes with low back pain: a systematic review and narrative synthesis

OBJECTIVE: To investigate the diagnostic accuracy of MRI for identifying posterior element bone stress injury (PEBSI) in the athletic population with low back pain (LBP). STUDY DESIGN: A systematic review searched for published sources up until July 2020. Eligibility criteria: prospective cohort des...

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Detalles Bibliográficos
Autores principales: Esh, Roy, Grødahl, Linn Helen J, Kerslake, Robert, Strachan, Kate, Spencer, Simon, Fawcett, Louise, Rushton, Alison, Heneghan, Nicola R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547544/
https://www.ncbi.nlm.nih.gov/pubmed/33088582
http://dx.doi.org/10.1136/bmjsem-2020-000764
Descripción
Sumario:OBJECTIVE: To investigate the diagnostic accuracy of MRI for identifying posterior element bone stress injury (PEBSI) in the athletic population with low back pain (LBP). STUDY DESIGN: A systematic review searched for published sources up until July 2020. Eligibility criteria: prospective cohort design, MRI diagnosis, adolescents/young adults, chief symptoms of LBP, PEBSI as the clinical diagnosis and SPECT-CT as reference standard. Risk of bias and overall quality were assessed using QUADAS-2 and GRADE, respectively. A narrative synthesis was conducted. RESULTS: Four studies were included, with three included in the quantitative synthesis. Compared with SPECT-CT, two studies involving MRI demonstrated sensitivity and specificity of 80% and 100%, and 88% and 97%, respectively. Compared with CT, one study involving MRI demonstrated sensitivity and specificity of 97% and 91%, respectively. Risk of bias was moderate to high although consistency across studies was noted. CONCLUSION: Findings support further research to consider MRI as the modality of choice for diagnosing PEBSI. MRI was consistent with SPECT-CT for ruling-in PEBSI, but the clinical value of cases where MRI had false negatives remains uncertain due to possible over-sensitivity by SPECT-CT. PROSPERO REGISTRATION NUMBER: CRD42015023979.